不同痰标本处理方法对结核分枝杆菌罗氏培养检测结果的影响  

The effect of different sputum processing methods on the results of Lwenstein-Jensen medium culture

作　　者：赵立平[1,2] 朱玛[3] 姜广路[1,2] 于霞[1,2] 黄海荣[1,2] 

机构地区：[1]国家结核病临床实验室 北京市结核病胸部肿瘤研究所 [2]首都医科大学附属北京胸科医院,101149 [3]成都市结核病防治院

出　　处：《中国防痨杂志》2013年第2期93-96,共4页Chinese Journal of Antituberculosis

基　　金：北京市重大科技攻关项目(D121100003012001)

摘　　要：目的分析采用简单法和离心法处理痰标本,以及采用离心法处理痰标本时不同离心条件对罗氏培养检测结果的影响。方法收集2010年9—11月北京市结核病胸部肿瘤研究所国家结核病临床实验室进行细菌学检查的疑似结核病患者痰标本198份,其中涂片阳性的痰标本99份,涂片阴性的痰标本99份。同时应用简单法和离心法对198份痰标本进行罗氏培养;离心法培养时分别采用5种不同的离心条件:3000×g离心15min、3000×g离心8min、3000×g离心25min、2000×g离心15min、5000×g离心15min。结果任何一种方法培养阳性即认定标本培养阳性,198份痰标本中共有126份培养阳性,其中97份来自涂阳痰标本,29份来自涂阴痰标本;简单法的阳性率为93.65%(118/126),离心法最高的阳性率为96.03%(121/126)。简单法的平均初生长时间为(20±8.56)d,离心法(3000×g离心15min)的平均初生长时间为(22±9.10)d,两者间差异有统计学意义(Z=-4.81,P<0.001)。在125份离心法培养阳性的标本中,3000×g离心15min、3000×g离心8min、3000×g离心25min、2000×g离心15min、5000×g离心15min,5种不同离心条件下的培养阳性率分别为96.03%(121/126)、89.68%(113/126)、95.24%(120/126)、92.06%(116/126)和96.03%(121/126)。结论罗氏培养过程中,简单法的阳性率与离心法接近,但由于简单法操作简单、污染率较低,初生长时间较短,因而可能更符合临床的需要;应用离心法进行罗氏培养时,离心力或离心时间的变化可能会影响培养的阳性率。Objective To evaluate the effect of different sputum processing methods on the results of Lwenstein-Jensen（L-J） medium culture.Methods 198 sputum specimens from suspected tuberculosis（TB） patients were collected,in which 99 samples were smear-positive and the others were smear-negative.Each sputum specimen was performed L-J medium culture simultaneously using the simple method and the centrifugal method,in which there were 5 following centrifugal conditions to be simultaneously used： 3000×g for 15 min,3000×g for 8 min,3000×g for 25 min,2000×g for 15 min,5000×g for 15 min.Results Of 198 sputum specimens,126 were culture-positive,in which 97 originated from smear-positive sputa,and 29 originated from smear-negative sputa.The positive rates for the simple method and centrifugal method（3000×g for 15 min） were 93.65%（118/126）and 96.03%（121/126）.The average culture time for the simple method [（20±8.56） days] was 2 day shorter than that for centrifugal method [（22±9.10） days].Of 125 culture-positive specimens by the centrifugal method,the positive rates at 5 centrifugal conditions mentioned above were 96.03%（121/126）,89.68%（113/126）,95.24%（120/126）,92.06%（116/126） and 96.03%（121/126）,respectively.Conclusion The sensitivity of L-J medium culture by the simple method was similar with the centrifugation method.The simple method has the advantages of simple operation,lower contamination rate,shorter culture time,and was adaptable to be used widely.The centri-fugal force and centrifugal time of the centrifugal method had some effect on the positive rate of culture.

关 键 词：分枝杆菌 结核 标本制备 痰 培养基 细菌学技术 

分 类 号：R446.5[医药卫生—诊断学]